Various probes are inserted into the esophagus for the purposes of medical diagnosis and/or therapy. Diagnostic probes include those for transesophageal echocard-iography (TEE). Transesophageal (TE) ultrasound probes consist of an elongate flexible shaft with a transducer on the distal end and a "control handle" on the proximal end. The handle contains controls for defecting the distal tip so that desired views of the heart are obtained.
TE ultrasound probes are preferred over transthoracic probes in certain cases where better quality images are obtained by TEE. Generally speaking, TEE images are superior to transthoracic images for two reasons. First, a TE probe is positioned closer to the heart so that acoustic attenuation is reduced and higher frequency sound waves may be employed. Second, because of probe positioning the sound waves from a TE probe are not hampered by ribs and lungs.
TEE applications include: detection of aortic dissections, locating clots in the left atrium, monitoring ventricular wall motion for myocardial ischemia during coronary bypass surgery, and detecting residual mitral regurgitation during mitral valve repair. Predicting obstructive coronary artery disease by visualizing aortic plaque is recently reported and a particularly exciting application.
Intubating the esophagus with current methods requires considerable experience and is sometimes difficult. Intubation is accomplished by anesthetizing the pharynx, positioning the probe in the back of the throat, asking the patient to swallow, and passing the probe into the esophagus.
There are several disadvantages to the current method of intubating the esophagus. First, the intubation can easily take 10 or 15 minutes. For example, the patient may have trouble swallowing the large diameter (approximately 1/2 inch diameter [1.27 cm]) TE probe. Also, the physician may have difficulty obtaining the best probe position because only tactile clues are available for probe guidance. Second, the present method occasionally produces tracheal intubation rather than the desired esophageal intubation. Third, certain patients cannot be intubated with a TE probe because of anatomic geometry. Fourth, certain anatomical details such as a pharyngeal pouch serve as contraindications for TEE. Fifth, the physician's fingers are subject to biting and risk of infection during the intubation procedure.
It is an objective of this invention to provide a device(s) which reduces the time required to place a TE probe into a patient's esophagus. Another objective of the invention is to provide a device(s) which ensures that the examiner intubates the correct lumen. Another objective is to provide a device(s) which minimizes intubation problems resulting from unusual anatomy. It is also an objective to provide a device which allows TEE in patients that would be contraindicated for the standard TEE procedure. A further objective is to provide a device which reduces the physician's risk of infection from bites obtained while placing a TE probe in the esophagus. An additional objective of the invention is to provide methods for placing a TE probe into the esophagus.
These and other objectives are obtained by the preferred embodiments described herein.